Nurwasis Nurwasis
Department Of Ophthalmology, Dr. Soetomo General Academic Hospital, Surabaya

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The Difference between hs-CRP and Serum IL-6 Levels in Patients with Glaucoma and Non Glaucoma Muhammad Riduan1, Endang Retnowati Kusumowidagdo1, Nurwasis1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3195

Abstract

Background: Glaucoma is a group of eye diseases that have the characteristic of optic nerve damage with a specific pattern and field loss of view with or without increased intraocular pressure (IOP). The objective of the study was to analyze the association between glaucoma incidence with hs-CRP and IL-6 levels. Method: This study used patients who fulfilled the inclusion criteria. Inclusion criteria were in the form of patients with a primary closed-angle diagnosis, willing to participate in the research. The study was conducted in the period from March to August 2013. The research procedure included patient examination, hsCRP and IL-6 level examination. Results: Mann-Whitney test result showed difference of hs-CRP with p value of 0.755 and difference of IL-6 level with p = 0.95. Thus, there was no significant difference in the levels of hs-CRP and IL-6 in patients with glaucoma and non-glaucoma. Conclusion: Hs-CRP and serum IL-6 levels in the glaucoma group did not differ from the non-glaucoma group.
Time-dependent Expression of Caspase-3 and Degeneration of Lateral Rectus Muscle on Experimental Esotropia in Rabbits Luki Indriaswati; Nurwasis; Gatut Suhendro; Soetjipto; Retno Handajani
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14785

Abstract

Background: To identify correlation between caspase-3 expression and degeneration of lateral rectus muscleon experimental esotropia in rabbits by using time dependent analysis. Methods: Twenty four rabbits weredivided into 4 groups, first month sham (S1); second month sham (S2); first month esotropia (E1); andsecond month esotropia (E2) model groups. Immunohistochemical and haematoxyllin eosin staining wereperformed. Results: In first month observation no significant difference in caspase-3 expression between S1(1.56 ± 1.03) and E1 (3.93 ± 1.66) groups (p >0.05) and in the degeneration score of lateral rectus musclebetween S1 (1.33 ± 1.36) and E1 (3.83 ± 2.04) groups (p> 0.05). In second month observation no significantdifference in caspase-3 expression between S2 (1.80 ±1.08) and E2 (6.50 ± 3.26) groups (p >0.05); butthere was significant difference in the degeneration score of lateral rectus muscle between S2 (1.16 ± 1.16)and E2 (4.50 ± 1.04) groups (p <0.05). There was a significant correlation between caspase-3 expressionand the degeneration score of lateral rectus muscle (p=0.020; r=0.471). Conclusion: On the experimentalesotropia with prolonged lateral muscle contraction in rabbits, the increasing trend of caspase-3 expressionhas a correlation with the increasing degeneration score of lateral rectus muscle.
Mechanism of Corneal Epithelial Cells Death by Infection of pseudomonas Aeruginosathrough Analysis Expression of Caspase-1, TNF, RIPK1, RIPK3, Caspase-3 in Rats Model Ismi Zuhria; Nurwasis; Eddy Bagus Wasito; Winarto; I Ketut Sudiana; Reny I’tishom; Nyilo Purnami
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15802

Abstract

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Evaluation of KI-67, Apoptosis, and Hyaluronic Acid in Grading Retinoblastoma Hendrian D Soebagjo; Nurwasis Nurwasis; Ugresone Y Bintoro; Sutiman B Soemitro
Folia Medica Indonesiana Vol. 55 No. 3 (2019): September
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.305 KB) | DOI: 10.20473/fmi.v55i3.15504

Abstract

Hyaluronic acid (HA) is a glycosaminoglycan with a straight-chain polymer arrangement defined as the extracellular matrix constituent. High molecular weight HA has normal physicochemical, biological, and physiological properties whereas low molecular weight has the property of angiogenesis, inflammation, and suppresses apoptosis. This study occupied the samples of 35 paraffin block from poorly and well differentiated retinoblastoma tissue and 8 normal retinal block which have been collected for 4 years from 2010-2013 at Dr. Soetomo Hospital, Surabaya, Indonesia. Afterwards, the paraffin blocks were immunohistochemically examined for HA staining, expression of cell proliferation (Ki-67), and cell apoptosis to determine intratumoral aggressiveness of retinoblastoma. HA on poorly differentiated retinoblastoma stain with a high immunostaining of 76.2%, while well differentiated retinoblastoma on the highest HA staining was revealed to be at moderate level of 64.3%, and not appear in normal retina. In poorly differentiated retinoblastoma, the location of most HA stain is in the cell cytoplasm (87.5%). In the well differentiated retinoblastoma, the HA immunostaning mainly occurred in the cell membrane (73.7%). Histopathological retinoblastoma grading showed a significant correlation (p <0.01) towards several variables of HA immunostaining, Ki-67, and cell apoptosis. In addition, the histopathological retinoblastoma grading also revealed a significant correlation (p <0.01) towards the location of HA staining (cell membrane and cytoplasm). Both stainings are also play role in retinoblastoma differentiation. The malignancy of retinoblastoma can be proven by the increased HA staining at cytoplasm in poorly differentiated and associated with increased of cell proliferation along with decreased apoptosis.
Difference of Heat Shock Protein 70 Serum Level Between Primary Angle Closure Glaucoma and Open Angle Glaucoma Patients: Indonesia Single Center Experience Mohamad Nurdin Zuhri; Nurwasis Nurwasis; Endang Retnowati; Windhu Purnomo
Folia Medica Indonesiana Vol. 57 No. 3 (2021): September
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (368.815 KB) | DOI: 10.20473/fmi.v57i3.23601

Abstract

This study aimed to analyze the differences in Hsp 70 serum levels in patients with primary angle-closure compared to patients with open-angle glaucoma at Dr. Soetomo General Academic Hospital, Surabaya, East Java. This cross-sectional study was conducted on 41 subjects divided into 2 groups consisting of 21 patients with primary angle-closure glaucoma and 20 patients with open-angle glaucoma. Anterior segment examination was assessed by slit-lamp biomicroscope examination. Intraocular pressure on both eyes was measured by Perkin’s tonometry. Posterior segment examination was performed with 78 D lens and anterior chamber angle was assessed by goniolens. The serum level of Hsp 70 was assessed using a human Hsp 70 sandwich ELISA kit. The data were statistically analyzed with the Mann-Whitney test. The mean serum levels of Hsp 70 in the primary angle-closure group was 5.55  4.75 ng/ml, while the open-angle group was 3.62  2.39 ng/ml (p = 0.134). There was no difference in Hsp 70 serum levels between the two groups, although the trend obtained serum levels of Hsp 70 patients with primary angle-closure was higher compared to patients with open-angle.
A Rare Case of Chronic Primary Angle-Closure Glaucoma in a Young Woman with Coexisting Pathologic Myopia Ni Putu Ayu Reza Dhiyantari; Nurwasis Nurwasis; Evelyn Komaratih; Yulia Primitasari
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1436.726 KB) | DOI: 10.20473/vsehj.v1i1.2021.10-16

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Introduction: Primary Angle-Closure Glaucoma (PACG) is usually present in adults older than forty and is more common in hyperopic eyes. Angle-closure is usually related to structural or developmental ocular abnormalities in young individuals. Case presentation: We presented a rare case of PACG in a 32 years old woman with pathologic myopia of -23.0 RLE. The chief complaint was blurring of the right eye three months before the visit. Right eye Intraocular Pressure (IOP) was 30mmHg-38mmHg despite treatment with three intra-ocular pressure-lowering agents. Axial length was 32.36 mm and 31.19 mm RLE. Anterior chamber depth was 2.36 mm and 2.60 mm RLE. Lens thickness was 5.07 mm and 5.40 mm RLE. Signs of GON and pathologic myopia were found in both eyes. GON was present asymmetrically (0.9 and 0.6 RLE), with the myopic crescent as well as baring and peripapillary atrophy. The optic disc was slightly tilted with the myopic crescent. There was also a marked sign of retinal pigment epithelium thinning and attenuation along with myopic chorioretinal atrophy. Conclusions: PACG in a young myopic individual is challenging to diagnose because myopia and glaucoma share similar optic nerve head pathology. Comprehensive examinations including gonioscopy, biometry, and OCT may confirm the diagnosis. In the presented case, angle-closure was caused by thick lenses and a shallow anterior chamber, along with excessively long axial length. Primary angle-closure at a young individual with myopic eyes is highly uncommon. Nonetheless, clinicians should always consider glaucoma even in the presence of high axial length and myopic fundus.
The Difficulties of Trabeculectomy in a Primary Angle-Closure Glaucoma Patient Herdina Ramadhani; Nurwasis Nurwasis; Yulia Primitasari; Evelyn Komaratih
Vision Science and Eye Health Journal Vol. 1 No. 2 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5082.62 KB) | DOI: 10.20473/vsehj.v1i2.2022.38-44

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Introduction: Trabeculectomy is an incisional surgery for glaucoma patient. Performing trabeculectomy in primary angle-closure glaucoma (PACG) is quite difficult. Caution is needed for the occurrence of flat anterior chamber (FAC) and malignant glaucoma. We present a case management of trabeculectomy in a PACG patient. Case presentation: A 52-year-old male had blurred vision in his left eye since one year ago. The patient felt left visual field narrowing since eight months ago. Patient had type 2 diabetes mellitus. Visual acuity on the left eye was 5/7.5. Intraocular pressure (IOP) increased (29 mmHg). Gonioscopy showed closed angle and peripheral anterior synechiae. Glaucomatous optic neuropathy was found with C/D ratio value of 0.9 and superior-inferior RNFL thinning on optical coherence tomography (OCT). Anterior segment OCT revealed shallow anterior chamber depth (ACD) 2.54 mm. The right eye visual acuity was 5/5, normal IOP, and shallow ACD (2.66 mm). Patient was underwent left eye trabeculectomy. Postoperatively, left eye anterior chamber and bleb were formed. He had normal IOP without glaucoma medications. Conclusions: Trabeculectomy is a surgical procedure for glaucoma. Close monitoring is required to avoid the risk of postoperative FAC and malignant glaucoma in PACG.
CONQUERING THE AMBIGUITY OF OPTIC ATROPHY IN NORMAL TENSION GLAUCOMA: FROM MYSTERY TO MASTERY: Poster Presentation - Case Report - Resident Hakim, Affannul; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/nha7y421

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Introduction : The dilemma in diagnosing glaucoma often arises when optic atrophy is found alongside nonspecific glaucomatous findings and normal intraocular pressure (IOP), particularly in cases of normal tension glaucoma (NTG). This gray zone often leads to doubt and misdiagnosis. Case Illustration : A 70-year-old man previously diagnosed with idiopathic bilateral optic atrophy complained of blurred vision in both eyes. The visual acuity was 5/5 in the right eye (RE) and hand movement in the left eye (LE). Both eyes had normal IOP, open angles with Sampaolesi lines on gonioscopy, fibrin deposits at pupillary margins, and a large cup-to-disc ratio with baring and peripapillary atrophy on funduscopy. The OCT examination revealed thinning in the ONH-RNFL, ILM-RPE, and GCL-IPL complexes. HFA revealed tunnel vision in RE and general depression in LE. The patient was suspected of having NTG. We performed BMO-MRW (less than 100 ?m in both eyes) and 24-hour ocular perfusion pressure (OPP) measurements (less than 50 mmHg at night) to support the diagnosis. Discussion : The BMO-MRW examination is a new parameter that can help establish the diagnosis of glaucoma. A thin BMO-MRW finding suggests that optic atrophy originates from glaucoma. It is important to perform a comprehensive examination in cases of NTG to identify risk factors and prevent the development of glaucoma. Decreased OPP to less than 50 mmHg and PEX syndrome may be risk factors for NTG. Conclusion : In cases of doubtful optical atrophy, it is important to consider the possibility of NTG by performing a comprehensive examination, including BMO-MRW and twenty-four hour OPP measurements.
ANGLE RECESSION, THE SEQUELA OF EIGHT-BALL HYPHEMA AFTER SPRAYED BY FIRE HYDRANT: A CASE REPORT: Poster Presentation - Case Report - Resident Asti, Annisa Kinanti; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/gkke0y72

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Introduction : Hyphema results from damage to the blood vessels of the iris or anterior ciliary body after blunt trauma, and in 56–100% of cases can occur angle recession. Case Illustration : A 40-year-old man complaints of pain and blurred left eye after being sprayed by a high-pressure fire hydrant five hours before coming to the emergency room. Visual acuity was 20/20 and hand movement in right and left eye, IOP is 13 mmHg and 18 mmHg in both eyes. Subconjunctival bleeding, conjunctival and pericorneal injections were found with punctate fluorescein test in the left eye. The cornea was edema and the anterior chamber was full of hyphema. Five days after being hospitalized and treated with topical atropine, antibiotics, and steroid in combination with oral tranexamic acid, the visual acuity was 5/6.5 and the hyphema was resolved. The IOP elevated after 1-6 weeks of follow-up in the outpatient clinic then timolol eyedrops were given. Gonioscopy showed widening of CBB, torn iris processus 2 clock hours in the inferior quadrant. The antiglaucoma medication was stopped due to the controlled IOP in the end episode of the treatment. Discussion : Angle recession involves a tear between the longitudinal and circular muscle fibres of the ciliary body. Medication is needed to control the IOP, while surgical management only indicated in cases where medical treatment fails to control the IOP and risk of progressive visual loss. Conclusion : Angle recession can occur after blunt eye trauma with hyphema and IOP control is needed to prevent the development of secondary glaucoma.
Various Corneal Foreign Body Materials Fitriani, Dila Nur; Nurwasis
Vision Science and Eye Health Journal Vol. 4 No. 1 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i1.2024.17-23

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Introduction: Cornea is an important refractive part of the eye. The corneal foreign body can disturb corneal function, depending on its material. Any materials are inert and can be retained with serial observation, while others can cause an inflammatory reaction. Purpose: To determine the effects of various foreign body materials on the cornea. Review: Corneal foreign body materials are divided into non-organic and organic materials. Organic foreign bodies (plant and insect parts) often cause severe inflammation; meanwhile, the effects of non-organic foreign bodies (metal, glass, graphite) depend on their materials. Some metals, such as iron and copper, can develop a stained deposition, disturb corneal clarity, and lead to inflammation. Other metals such as gold, silver, and platinum are almost inert and cause little or no reaction. Glass, sand, or stone is relatively inert if it is sterile. Intrastromal graphite is also inert, however, organic materials are associated with infection. Wood can lead to bacterial or fungal infection. Insect parts such as caterpillar hair can cause ophthalmia nodosa, and insect stings elicit an inflammatory response. Conclusions: Any non-organic corneal foreign bodies (gold, silver, platinum, glass, sand, stone, and graphite) may be retained safely if the removal of the foreign body results in significant scarring, which can distort the topography of the cornea. Iron, copper, and organic materials (wood and insect parts) must be removed due to their toxicity or risk of infection.